Sign our change.org petition asking Members of Congress to Protect, Improve, and Expand medicare to all!

]]>2Benhttps://www.healthcare-now.org/?p=84012015-07-14T17:07:21Z2015-07-14T17:07:21ZThe AFL-CIO has endorsed the National Day of Action to Protect, Improve and Expand Medicare to All being organized by Healthcare-NOW! and our national allies on July 30, 2015. AFL-CIO President Richard Trumka circulated this letter to the AFL’s 56 affiliated unions and their 12.5 million members, urging them to mobilize for Medicare’s 50th Anniversary, because:

[A]dopting “Improved Medicare for All” is the only solution to the increasing cost and access problems of our current healthcare system.adopting “Improved Medicare for All” is the only solution to the increasing cost and access problems of our current healthcare system.

You can use this online tool to find contact information for the state AFL-CIO and central labor councils in your area to get them involved in a Medicare’s 50th action you are involved in.

Check here for Healthcare-NOW!’s comprehensive list of Medicare’s 50th anniversary actions being organized across the country.

]]>0Benhttps://www.healthcare-now.org/?p=82632015-06-05T16:51:33Z2015-06-04T17:46:05ZBenjamin Day, Executive Director for Healthcare-NOW!, delivered the keynote address for the 12th Annual State Conference of Single-Payer Action Network Ohio on “The State of the Single-Payer Movement and Movement Action Planning.” The keynote provides a detailed analysis of how to evaluate social movements as opposed to campaigns, why it is that most activists in most social movements believe they are not winning – even when they are, and compares the single-payer movement with other recent social movements such as Occupy and Black Lives Matter. The answers will surprise you!

On Wednesday, May 27, the New York State Assembly passed the “New York Health Act” universal health care bill (A. 5062/S. 3525) by a vote of 92 to 52. New York Health would provide universal, comprehensive health care to all New Yorkers without premiums, co-pays, deductibles, or limited provider networks.

“Assembly passage of New York Health will elevate the issue on the public agenda and change the conversation from ‘it’s a great idea that will never happen’ to a truly achievable goal,” said Assembly Health Committee Chair Richard N. Gottfried, lead Assembly sponsor of the bill.

The last time a universal health care bill was on the Assembly floor was 1992. It passed with a solid majority. “But then, the focus of reform shifted to Washington. While the federal Affordable Care Act has done a lot of good, it’s clear that a lot of problems remain – and if we want to fix them, we have to do it ourselves,” Mr. Gottfried said.

According to an analysis by University of Massachusetts/Amherst Economics Department Chair Gerald Friedman, 98% of New Yorkers would spend less for health coverage and health care under New York Health than they do today. New York would save over $70 billion by eliminating health insurance company administration and profit; reducing health care provider and employer administrative costs; and capturing savings from negotiating prices of pharmaceuticals and medical devices. Even after expanding coverage to all New Yorkers; eliminating deductibles, co-pays, and out-of-network charges; and increasing low Medicaid reimbursements, New York Health would generate net savings of $45 billion.

“Funding and administering health insurance is the primary uncontrolled burden on local budgets,” said Albany City Treasurer Darius Shahinfar. “The question for me is how these hidden costs of health care – insurance company profit, administrative waste and inefficiency, mandatory local Medicaid spending – affect our local taxes. The facts are undeniable: New York Health, based on my conservative estimates, would reduce City and School District tax rates by at least 20% and could eliminate many County property taxes entirely. Getting full health care coverage while cutting property taxes seems like a no-brainer to me.”

In December and January, the Assembly Health Committee held hearings on the bill in Syracuse, Rochester, Buffalo, New York City, Mineola, and Albany. The Committee heard testimony from almost 200 witnesses including New Yorkers with insurance who are bankrupted by their deductibles; patients who lose trusted providers due to restricted networks; doctors who spend hours on the phone negotiating with insurance bureaucrats; and medical students who “signed up for medical school, not business school.”

“Our healthcare system is fundamentally damaged. Too many parties are in it to make a buck off the misfortune of the sick and injured. That’s why NY needs to create a single payer healthcare system that cares for all patients without the interference of predatory insurance companies and other profit-driven enterprises seeking to drain the system,” said Judy Sheridan-Gonzalez, an RN at Montefiore Medical Center in the Bronx and president of NYSNA. “Only under a system of universal access to care based on the highest quality for everyone – not on ability to pay, social status, or any other demographic impediment – will there be enough resources directed to the proper care for patients.”

The New York Health Act removes financial barriers to health care – the co-pays and deductibles – that keep some of my patients from seeing me when they need to,” said Oliver Fein, MD, Chair of Physicians for a National Health Program-NY Metro. “I also wouldn’t have to worry about my patients affording the medications, lab tests or consultations that they need. I wouldn’t have to waste countless hours fighting insurance companies to approve necessary medical care. The New York Health Act is a universal, single payer system that would guarantee equal access to care that is funded fairly – something every New Yorker and resident of this country deserves.”

New York Health would be a boon to business. Employer spending on health care eats up a median 12.8% of payroll costs on health insurance, up more than 50% in a decade, with small businesses spending even higher percentages. According to the Friedman study, New York Health could be funded through an income assessment averaging just 8.1% of payroll.

“New Yorkers deserve better,” said Assembly Member Gottfried. “We should be able to go to the doctor when we need to, without worrying whether we can afford it. We should choose our doctors and hospitals without worrying about network restrictions. We deserve health coverage for all of us, paid for based on our ability to pay, not what the market will bear. I’m proud the Assembly has passed the New York Health Act, and I look forward to working with a great community of advocates including medical professionals, medical students, organized labor, and Senate sponsor Bill Perkins, to enact it into law.”

New York Health has been endorsed by the NYS Academy of Family Physicians, NYS American Academy of Pediatrics, NYS Nurses Association, Committee of Interns and Residents, Doctors Council SEIU, NY chapter of Physicians for a National Health Program, SEIU 1199, NYS AFL-CIO, Communications Workers of America, Amalgamated Transit Union Local 1056 and 1179, United Auto Workers 9 & 9A, UFCW Local 1500, Capital District Area Labor Federation, Local 32BJ SEIU, NYSUT, United Federation of Teachers, Working Families Party, Green Party, Citizen Action, StateWide Senior Action Council, NYPIRG, League of Women Voters, and others.

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]]>10Benhttps://www.healthcare-now.org/?p=82662015-06-04T19:08:19Z2015-06-01T18:18:58ZStarting June 2015, Healthcare-NOW! has moved its offices from Philadelphia to Boston! We are sharing office space with Mass-Care, the Massachusetts Campaign for Single Payer Health Care in the heart of downtown Boston, right on the Boston Common and a block from the Massachusetts State House. Our phone and email contact information remain the same as always, but mail should be sent to our new address:

]]>0Benhttps://www.healthcare-now.org/?p=80962015-04-15T19:24:37Z2015-04-15T19:24:37ZDuring a press conference prior to the first of six public hearings held by the New York Assembly across the state, Assemblyman Richard Gottfried, Chair of the Assembly Health Committee since 1987, was asked by a reporter whether his legislation for universal, public health coverage for all of New York would limit patients’ choice of providers… Watch as Assemblyman Gottfried flips the script on the reporter, and paints a picture of how inhumane and dysfunctional our fire services would be if they worked like the U.S. healthcare system!

The Chattanooga Area Labor Council endorsed HR 676 at its regular monthly meeting March 23, 2015, reports Gary Watlkins, Council President. HR 676 is the national single payer health care legislation sponsored by Congressman John Conyers (D-MI). The bill currently has 48 co-sponsors including Rep. Steve Cohen of Memphis,Tennessee.

“If passed, HR 676 would remove a great impediment to contract negotiations,” said Watkins in an interview with the All Unions Committee for Single Payer HR676. “I think employees would realize great improvements in their health and finances and at the same time employers would be the beneficiaries of a better educated and healthier and more productive work force. If everybody had health insurance, everybody would have a better opportunity at education,” Watkins continued.

Earlier in the year, Dr. Laura Helfman of Physicians for a National Health Program, made a single payer health care presentation to an open meeting of the labor council at Local 175 IBEW, President Watkins’ home local. Dr. Helfman practices Emergency Medicine at Children’s Hospital at Erlanger in Chattanooga and lives in Coalmont. Her father and grandfather both were proud members of the IBEW.

In addition to union delegates and allied organizations, State Representative JoAnne Favors attended the meeting. With her background in nursing and her concern for health care, she expressed her thanks for the program and her support for the Conyers bill.

During the lively discussion period following the talk, many council delegates spoke of their current difficulty in bargaining for and maintaining health care for members and families.

President Watkins expressed his thanks “for bringing such a great informational program to us,” and added, “We look forward to working with you and other leaders in bringing this legislation to the forefront.”

Chattanooga is the 5th labor council in Tennessee and the 150th in the nation to endorse HR 676. Other Tennessee councils that have endorsed are located in Nashville, Memphis, Knoxville-Oak Ridge, and Jackson.

Dr. Art Sutherland, a Tennessee cardiologist and Board Member of Physicians for a National Health Program, has offered to provide a single payer presentation to any Tennessee union that requests it, and the national PNHP can offer the same to unions across the country.

]]>1Benhttps://www.healthcare-now.org/?p=80932015-04-15T19:12:29Z2015-03-26T19:07:04ZFrom Ida Hellander, Director of Policy and Programs at Physicians for a National Health Program, appearing in Truthout
March 26, 2015

The bipartisan “Doc Fix” legislation (H.R. 1470, now H.R. 2) and proposed amendments will undermine traditional Medicare and advance the goal of privatization, according to Dr. Don McCanne in a series of posts to his popular health policy blog, the Quote of the Day. If enacted as it presently reads, it will:

1. Limit choice of physician in traditional Medicare. Physicians in traditional Medicare would be subject to onerous new documentation requirements for payment and financial incentives to avoid complex patients under the proposed “Merit-based Incentive Payment System.” The additional paperwork burden will push physicians to stop seeing patients with traditional Medicare, retire, avoid older and sicker patients, or go to work for large organizations using “alternative payment models” (which are exempt from the requirement and more likely to have contracts with private Medicare plans).

2. Reduce access to care in traditional Medicare.Imposes a deductible that cannot be covered by Medigap insurance (starting in 2020) to encourage patients to join a private plan. The current Part B deductible is $147 annually, although that figure has been rising in recent years; 95 percent of traditional Medicare beneficiaries have supplemental insurance that covers the deductible and other cost sharing in Medicare. The only way to avoid the deductible in the future will be to join a private Medicare Advantage plan.

3. Raise Medicare’s costs by driving more patients into private MedicareAdvantage plans. Private plans have already cost Medicare an excess of more than $282 billion since 1985. Mandatory deductibles and reduced access to physicians in traditional Medicare will drive more patients into private Medicare Advantage plans, which are more costly than the cost of caring for patients in the traditional fee-for-service program. Although Obamacare was supposed to reduce the amount the private plans are overpaid (the “Medicare cuts” in Obamacare), these have been mostly offset by “adjustments” and “quality awards” by the Department of Health and Human Services.

4. Undermine Medicare‘s popular support by requiring higher income seniors to pay higher premiums (means testing). Under means-tested premiums, higher-income individuals will be required to pay larger premiums, undermining the support of this influential group for Medicare program. Although the income subject to extra premiums is high, it can always be reduced in the future.

5. Ending the SGR should cost $20 billion, not $210 billion. These drastic measures aren’t even necessary. According to Bruce Vladeck, a former top administrator at Medicare, “Since the Sustainable Growth Rate (SGR) was implemented in 1998, total Medicare physician expenditures have exceeded the allowed amounts by only $20 billion (on a total of almost $1 trillion). To recoup that all in one year would require a 21 percent reduction in fees for one year. And those reduced fees would then become the base for payment levels in all subsequent years. In a rational world, Congress would write off the $20 billion as a relatively small policy error and establish a more realistic prospective formula. But under Congressional budget rules, the cost of doing so is not $20 billion, but $20 billion per year, compounded by inflation, times 10 years.”

6. The GOP sees this bill as a step towards their longer-term goal of turning Medicare into a voucher program for private plans, shifting more costs onto patients. Rep. Mick Mulvaney, R-S.C., a staunch conservative, told the Washington Post he is supporting the bill because it will lead to much greater savings beyond the traditional 10-year time frame for estimating costs. Newt Gingrich stated the GOP’s goal succinctly in 1996: “Now, we don‘t get rid of it [Medicare] in round one because we don‘t think that that’s politically smart, and we don‘t think that’s the right way to go through a transition. But we believe it’s going to wither on the vine because we think people are voluntarily going to leave it — voluntarily.”

Restricts abortion, adds funds for war
* Makes Hyde Amendment permanent law. Since the ACA is a permanent statute, any amendment to any part of the ACA becomes part of U.S. Code.
* $94 billion in additional military spending in an “off-budget account.”

Dr. Ida Hellander

]]>4Benhttps://www.healthcare-now.org/?p=80022015-03-12T16:42:33Z2015-03-12T16:22:39ZThe International Journal of Health Services published a research paper by Healthcare-NOW!’s Executive Director, Benjamin Day, PNHP co-founders David Himmelstein and Steffie Woolhandler, and former Healthcare-NOW! intern Michael Broder, titled “The Affordable Care Act and Medical Loss Ratios: No Change in First Three Years.” The article found that, despite the promise of the Affordable Care Act to reduce health insurers’ overhead spending and thereby to increase the share of patients’ premiums that goes toward medical spending, overhead waste has not gone down since implementation of the law. The joint press release from Healthcare-NOW! and PNHP is below:

FOR IMMEDIATE RELEASE
March 12, 2015

Health law hasn’t cut insurers’ rate of overhead spending: study

Study finds Affordable Care Act’s requirement that health insurers spend at least 80-85 percent of premiums on actual medical care had no impact in the law’s first three years

Despite claims by the Obama administration that the Affordable Care Act will reduce health insurance companies’ spending on overhead, thereby channeling a greater share of consumers’ premium dollars into actual patient care, insurers’ financial filings show the law had no impact on the percentage of insurer expenditures on such things as administration, marketing and profits.

That’s the chief finding of a team of researchers, including two prominent physicians on the faculties of the City University of New York’s School of Public Health and Harvard Medical School, in an article published Wednesday in the peer-reviewed International Journal of Health Services.

Examining U.S. Securities and Exchange Commission filings of nine large insurers, and using a constant definition of what constitutes an insurer’s “medical loss ratio” or MLR – i.e. actual spending on payments to doctors, hospitals, pharmacies, etc. – the researchers found that the weighted average MLR in the three years after the new ACA regulations took effect (2011-2013) was 83.05 percent, compared to 83.04 percent in the three years prior to the reform.

The ACA sets limits on insurers’ overhead, mandating an MLR of at least 80 percent in small-group markets and 85 percent in the large group market. However, the Obama administration changed the traditional yardstick by which the MLR is measured.

The new way of calculating the MLR allows insurers to classify most expenditures on “quality improvement” initiatives and the updating of coding systems as medical expenditures, and allows them to subtract most taxes, regulatory fees and “community benefit” spending.

“Rather than go along with the administration’s moving of the goal posts to the apparent advantage of the insurers, we stuck with the traditional way financial analysts and insurance firms calculate MLR, namely, by dividing total medical payments by total premium income,” said Benjamin Day, the study’s lead author.

“What we found is that there’s been no significant change in the insurers’ MLR since the implementation of the new regulations.”

MLRs fell at four firms – UnitedHealth, Humana, Aetna and WellCare – and increased slightly at four others and markedly at one (Centene, a major managed Medicaid contractor).

Day continued: “Although the MLR requirements forced insurers to pay rebates of $1.1 billion in 2011 and $504 million in 2012 – payments that were touted by the Department of Health and Human Services as a major boon to consumers – these rebates constituted less than 0.1 percent of private insurance company revenues and appear to have had no overall impact on MLRs.”

Day, whose published research includes articles on labor history and health care reform, currently serves as executive director at Healthcare-NOW, a national coalition of groups advocating for a single-payer health care system.

Senior author Dr. Steffie Woolhandler, professor at the City University of New York’s School of Public Health at Hunter College and co-founder of Physicians for a National Health Program, said a number of factors might explain why the ACA hasn’t raised MLRs.

“Most plans already met the MLR requirement from 2007-2009, even without the MLR redefinition in the ACA,” Woolhandler said. “Moreover, self-insured employer plans, which accounted for 60 percent of all covered workers in 2011, were entirely exempt from the MLR requirement. In addition, a number of exemptions and adjustments were granted to a wide spectrum of plans and to several states, temporarily nullifying the new mandate.”

Woolhandler observed that traditional Medicare’s overhead is about 2 percent, i.e. 98 percent of Medicare’s spending goes toward medical care. “The ACA is too lenient on private insurers, sets too low a bar for their payments for actual care, and provides them with too many loopholes.

The full text of the article is available at the links above or from Mark Almberg at mark@pnhp.org.

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The International Journal of Health Services (joh.sagepub.com) contains articles on health and social policy, political economy and sociology, history and philosophy, ethics and law in the areas of health and health care.